Pulmonary Diffusing Capacity in Patients with Liver Cirrhosis.
- Author:
Mun Seung PARK
;
Geun Tae PARK
;
Jin Bae KIM
;
Seon Ho HWANG
;
Ho Joo YOON
;
Joon Soo HAHM
;
Choon Suhk KEE
;
Kyung Nam PARK
;
Min Ho LEE
- Publication Type:Original Article
- Keywords:
Chronic liver disease;
Pulmonary Function test;
Diffusing capacity;
shunt index;
Pitting edema
- MeSH:
Anoxia;
Edema;
Fibrosis;
Heart Diseases;
Humans;
Liver Cirrhosis*;
Liver Diseases;
Liver*;
Lung;
Oxygen;
Pulmonary Diffusing Capacity*;
Respiratory Function Tests
- From:Korean Journal of Medicine
1997;53(1):1-7
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
About a third of the patients with decompensated liver cirrhosis have reduced arterial oxygen saturation and are sometimes cyanosed in the absence of any apparent lung or heart disease; There is a reduction of diffusing capacity without a restrictive ventilatory defect. The aim of this study was to determine diffusing capacities in patients with chronic liver- diseases. The diffusing capacities and arterial oxygen saturations were measured in 25 patients with chronic active hepatitis(CAH), 9 early cirrhotics (early LC), 36 cirrhotics(Child's class A) and 11 cirrhotics(Child's class B). The anterior tibial area was observed for pitting edema, and Thallium-201 test per rectum(shunt index) was done. Hypoxemia was not observed in all subjects. The number of cases with decreased pulmonary diffusing capacity (DLco) is 3/25(12.0%) for CAH, 3/9(33.3%) for CAH with early liver cirrhosis(LC), 17/36(47.2%) for LC(Child's class A) and 6/11(54.5%) for LC(Child's class B). The mean+/-standard deviation of Dlco(% predicred) are 93.1+/-12.1 for CAH, 85.7+/-12.3 for CAH with early LC, 82.2+/-14.7 for LC(Child's class A) and 80.4+/-6.9 for LC(Child's class B), There is a significant difference between DLco in CAH and that in LC(Child's class A)(p<0.01). Patients with higher shunt index(>0.3) had significantly lower DLco than these with lower shunt index(<0.3)(76.4+/-9.7% vs. 89.3+/-13.3%)(p<0.01). The DLco was also lower in patients with pitting edema(77.3+/-10.2%) than in those without pitting edema(85.5+/-13.8%) (p<0.01). These results summarized that the DLco was low in patients with cirrhosis and with higher shunt index(>0.3) or pitting edema. This may be due to an increased systemic blood flow shunt and an increased generalized interstitial edema. Pulmonary function tests including diffusing capacity may be useful as prognostic parameters in patients with chronic liver disease, especially in those with CAH or early LC.
